Obstructive sleep apnea detection and prevalence in men and women using a continuous large U.S. sample by home under-mattress devices.

BACKGROUND

Obstructive sleep apnea (OSA) often goes undiagnosed, hindering timely intervention. This condition is associated with adverse cardiovascular and metabolic outcomes.

OBJECTIVES

To investigate the prevalence of OSA in a large real-world U.S. sample, as well as night-to-night variability in OSA detection using home under-mattress sleep monitoring devices.

METHODS

We analyzed de-identified sleep and respiratory data from over 47 million nights recorded by the Sleeptracker-AI Monitor in 151,013 individual-years between September 1, 2021, and August 31, 2023. Individuals with at least 300 recorded nights in one of two one-year study periods (September to August) were included on the first year they met this criterion. Each one-year study period for each individual was analyzed, with mean AHI for the one-year period used to determine OSA categories.

RESULTS

A total of 12,400,521 recorded nights from 38,084 participants across the two one-year cohorts (17,516 men, 15,360 women, and 5208 undisclosed gender) were analyzed. OSA (AHI ≥5) prevalence [95 % CI] among individuals with normal BMIs (<25kg/m2) increased with age: women <50 years, 2.8 % [2.2 %, 3.5 %]; women ≥50 years, 16.1 % [14.6 %, 17.8 %] (OR: 6.8 [5.2, 8.7]); men <50 years, 11.2 % [9.7 %, 12.7 %]; and men ≥50 years, 37.5 % [34.8 %, 40.2 %] (OR: 4.8 [4.0, 5.7]). Moderate-to-severe and severe OSA subjects showed a ≥2-category severity reduction (moderate to normal or severe to mild/normal) on 5.1 ± 7.6 % and 5.3 ± 6.9 % of nights (mean ± SD), respectively. Maximum AHI values from 3 randomly selected nights demonstrated sensitivities/specificities [95 % CIs] of 95.2 % [94.2, 96.1]/94.4 % [94.2, 94.7] (moderate-to-severe OSA), and 95.6 % [93.7, 97.2]/98.0 % [97.9, 98.1] (severe OSA), categorized by mean AHI over 1 year.

CONCLUSION

OSA prevalence increased with age in both genders, with higher rates in men and women≥ 50 years. Meanwhile, 5.1 % and 5.3 % of nights in moderate-to-severe and severe OSA cases had a 2-category lower OSA classification than their mean AHI category for that year.